Hospitals Urged To Help Smokers Quit Counseling For Patients Proposed By Doctor At Bethlehem Conference

June 13, 1992|by KATHY LAUER-WILLIAMS, The Morning Call

Area hospitals were encouraged to offer smoking-cessation counseling in conjunction with the no-smoking policy mandated by the Joint Commission of Accreditation on Healthcare Organizations at a one-day conference yesterday at the Holiday Inn in Bethlehem.

Dr. Steve Herman, clinical assistant professor of medical psychology at Duke University Medical Center in Durham, N.C., led the conference, which included an information session on smoke-free policies and clinical training for smoking cessation counselors.

On the heels of the mandate, Herman discussed ways hospital staff could use the forced abstinence of a hospital stay to help patients quit smoking permanently.

Since 1983, Herman has served as director of Duke's "Quit Smoking Consultation Service," a program which provides counseling to hospitalized smokers.

The mandate which went into effect Jan. 1 requires all hospitals seeking accreditation under the Hospital Accreditation Program to implement a smoke-free policy within two years.

"It's a movement that's gaining momentum," said Herman. "I'm convinced it's do-able anywhere. I come from a facility founded on tobacco money, and we were able to (become smoke-free) in the middle of the tobacco producing area."

Most area hospitals already have smoke-free policies, including Easton Hospital, Muhlenberg Hospital Center, Gnaden Huetten Memorial Hospital, Lehigh Valley Hospital and Allentown Osteopathic Medical Center (except for its evening detoxification center). St. Luke's Hospital is planning to become smoke-free this year, while Good Shepherd and Sacred Heart Hospital have designated smoking areas.

Herman said when smokers enter the hospital they are perfect candidates for a counseling intervention program.

"They are already concerned about their health condition," he said. "They are in a different environment in which there are not a lot of people smoking, and many are medicated and may go through nicotine withdrawal without realizing it. They never really miss cigarettes until they are getting better and think about going home."

Although he said the smoke-free policy was started to benefit non-smokers he sees it as a tremendous opportunity to help smokers quit.

"Most people want to quit," he said. "If they stop while they're in the hospital they can either continue abstinence after they leave or go back to smoking. It depends what kind of counseling they get."

He said Duke's program has been successful and 47 percent of the patients in the program still had not smoked one month after they left the hospital. An additional 31 percent decreased cigarette consumption, and of heart attack patients, 75 percent were still abstinent a year later.

He also suggested hospitals use the nicotine skin patch to help people who are nicotine-dependent.

"Nicotine is a very addictive substance," he said. "Smokers will go through withdrawal if they stop smoking."

He said withdrawal, which can include craving, anxiety, irritability and nervousness, peaks in the first day or two and then eases off by the end of the first week.

The patch is "the most effective procedure in the short run, but there has to be lifestyle changes," he said, adding it's a temporary help to ease the withdrawal symptoms in heavily dependent smokers. "We don't want people to be stressed out or be upset when they're in the hospital."

He also suggested ways hospitals could make smoke-free policies more effective and humane by offering smoking cessation to employees and counseling to those who smoke and experience stress from restricted smoking.

The conference was sponsored in part by Marion Merrel Dow, Inc. and the Coalition for a Smoke-Free Valley.